It is unclear how dynamic changes in pulmonary-capillary blood volume (Vc), alveolar lung volume (derived from end-inspiratory lung volume, EILV) and interstitial fluid (ratio of alveolar capillary membrane conductance and pulmonary capillary blood volume, Dm/Vc) influence lung impedance (ZT). The purpose of this study was to investigate if positional change and exercise result in increased EILV, Vc and/or lung interstitial fluid, and if ZT tracks these variables. Methods: 12 heart failure (HF) patients underwent measurements (ZT, EILV, Vc/Dm) at rest in the upright and supine positions, during exercise and into recovery. Inspiratory capacity was obtained to provide consistent measures of EILV while assessing ZT. Results: ZT increased with lung volume during slow vital capacity maneuvers (p<0.05). Positional change (upright→supine) resulted in an increased ZT (p<0.01), while Vc increased and EILV and Dm/Vc decreased (p<0.05). Moreover, during exercise Vc and EILV increased and Dm/Vc decreased (p<0.05), whereas, ZT did not change significantly (p>0.05). Conclusion: Impedance appears sensitive to changes in lung volume and body position which appear to generally overwhelm small acute changes in lung fluid when assed dynamically at rest or during exercise.
- Fluid accumulation
- Heart failure
- Lung impedance
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine